An exploration of the UK unpaid carer's world

   A black picture often within the world of dom-care staff on zero-hours contract, with disallowed travel time.

Contents                                                                      

       A paper distributed to Promoting Independence* on 4th February 2016 was based on this page. That paper is here.

        * A Herefordshire Council  engagement workshop for care provision stakeholders

1. Home care - NICE guidelines
2. Home care workers - newspaper reports
3. Time to Care
4. Recruiting and training home care workers and their organisers
5. What changes are in the offing?
6. Herefordshire Council - the truth

Notes to a non-specific dom-care company

Further to our phone conversation last Thursday, please pass this to rota staff.

I expect carers to arrive as stated on the rota  sent.

Paid carers not within your company attend at weekends in the morning  and every bedtime.  My back problems dictate that my wife's dressing routine is carried out by others.  This fact has been taken into account by a senior OT in the context of the most recent AWB assessment.

Most Thursdays mean a 0900 start as we leave at 0945 in the direction of the local daycare centre.  Mrs X arrived after my wife had been dressed by me and was most embarrassed at the situation.  I went out of my way to stress that it was not Mrs X's  fault.                                       

There have been other late arrivals and I have said nothing.  I now have had enough of this nonsense.

Please ensure that the stated rota actually means something.

I also went out of my way to defend all carers who are in the position of arriving late through no fault of their own, in the presence of the CEO and Board Chairman.  They took no notice of my defence then and obviously, have continued in that manner since.

This page is recommended reading for all staff.

Crucially -

3.4

Organisers should be given 8, 9 & 10 hour shifts until they develop sympathy.

That means they work the same shifts as given to those they send to face impossible rotas.

 

SCIE - Social Care Institute for Excellence      Google           

Trouble at mill                                                                                              

To any carer in dispute with the dom-care provider  

Travel time

It is inconceivable that the visit allocation software cannot allow for travel time. 

If your dom-care company tries to explain away late arrival of its carers by saying that "We have other clients to deal with as well, you know.", say this:

"Go to your contract with the local council.  Look for 'Domestic carer arrival time - 70% or less success in being on time is perfectly acceptable.'.

If it does not include such a statement, you should operate to 100%."

If it says that no travel time is allowed just say:

"That is ridiculous."

23 Sept news here  - much text on this page emanates from there.

Emboldened text within link lists means that ensuing text etc stems from the emboldened text.  

Certain underscored text has been thus treated as its mass would be inappropriate, or its is a supplementation as in 4 in the Contents list.  Other chunks may be prefaced Consider this text all in bold.

Contents

1. Home care - NICE guidelines
2. Home care workers - newspaper reports
3. Time to Care
4. Recruiting and training home care workers and their organisers
5. What changes are in the offing?
6. Herefordshire Council

1.2

Guidance -  Who is it for?

• Health and social care practitioners
• Home care provider organisations
• Home care managers and workers
• Older people using or planning to use home care services, and their carers.

Commissioners of home care services should ensure any service specifications take into account the recommendations in this guideline.

1. 3  Recommendations

The guideline includes recommendations on:

• Ensuring care is person centred
• Providing information about care and support options
• Planning and reviewing home care and support
• Delivering home care     1.3.1
• Joint working between health and social care
• Ensuring safety and safeguarding people using home care services
• Recruiting, training and supporting home care workers  4.1 and following

      source here

1.3.1  Delivering home care

Contracting home care

1.4.1 Ensure service contracts allow home care workers enough time to provide a good quality service, including having enough time to talk to the person and their carer, and to have sufficient travel time between appointments. They should ensure that workers have time to do their job without being rushed or compromising the dignity or wellbeing of the person who uses services.

source

Common sense and common knowledge. 

2   Home care workers - newspaper reports

Home care workers to have sufficient travel time between appointments  -  newspaper reports here

2.1

Home care workers must be given enough time to spend with elderly and disabled people and must have enough travelling time between appointments, a health watchdog has said.  source here  also header graphic source

2.2

Not allowing travel time leads to shorter visits as seen in this extract:

In England, 60% of councils use 15-minute visits, which are not long enough to provide adequate care, Leonard Cheshire Disability says.

The charity says such visits can "force disabled people to choose whether to go thirsty or to go to the toilet".  here

2.3

HOME CARE STAFF SHOULD BE GIVEN ENOUGH TIME TO PROVIDE GOOD SERVICE - WATCHDOG

Home care workers must be given enough time to spend with elderly and disabled people and must have enough travelling time between appointments, a health watchdog has said.

The National Institute for Health and Care Excellence (Nice) said home help visits of less than 30 minutes were not acceptable unless part of a wider package of support.

It has published new guidance for councils that commission care as well as firms providing services.         source here

pagetop here

3   Time to Care  

Introduction by the Carerworld website author

The following text is taken from  The Cavendish Review, An Independent Review into Healthcare Assistants and Support Workers in the NHS and social care settings.      

by Camilla Cavendish here

The text

3.1

An inescapable fact is that good caring takes time. It will not be possible to build a sustainable, caring,

integrated health and social care system on the backs of domiciliary care workers who have to travel long

distances on zero hours contracts, to reach people who have to see multiple different faces each week. Local

authorities must start to commission for outcomes, not by the minute – which is a false economy when so

many staff are quitting ... And staff must be paid for travel time, since non-payment can

push their earnings below the National Minimum Wage.       page 7

3.2

Statutory guidance should require councils to include payment of travel time as a contract condition

for homecare providers.             page 10

Consider this text all in bold

3.3

Summary

At its core, caring is about building relationships. Caring properly takes time.

Some low paid HCAs and support workers will heroically keep going as long as they feel they are still

giving good care. But the advent of zero hours contracts, fee cuts and no payment for travel time is

making it financially prohibitive for some domiciliary care workers to struggle on. Attrition rates are

already dangerously high: and they will only increase when carers feel that they can no longer even give

good care. Society will lose some talented carers unless the commissioning process changes radically and

Government starts to move money from health to reward social care for its contribution to lowering

NHS costs.

It is also questionable whether long shifts, of 12 hours and more, are conducive to compassionate care.

page 78

3.4

Organisers should be given 8, 9 & 10 hour shifts until they develop sympathy.

3.4

For home care workers on zero-hours contracts, who are not guaranteed a fixed number of hours

work per week, the need to travel for longer distances to do fewer visits is making it harder to make

ends meet. The fact that some employers will not pay for travel time between clients means that

there are now serious questions about whether some workers are actually being paid less than the

National Minimum Wage. UNISON has calculated that 200,000 care workers may be in this

situation.

page 81

3.5

Financial constraints are increasing the pressure for care to be delivered in as little time as possible –with some local authorities commissioning care services by the minute and failing to pay staff for travel time in between each visit. However, any cost savings generated from commissioning in such a way may be off-set by higher attrition rates, a lack of continuity of care for individuals and, of course,negative impact on staff’s health and well-being. Similarly, not paying staff for travel time is a false economy which is making some of these jobs simply unsustainable. 

page 82

Read the full report here.

pagetop here

4   Recruiting and training home care workers and their organisers

4.1

Consider involving people who use home care and their carers in recruiting and training home care workers.

source  1.7.2 here.

4.2

This is a very important recommendation which might be extended to recruiting and, just as important, monitoring those who organise home care workers.  

1. With tight budgets etc, the organisers, too, are under stress   
2. 
   
3. However, that is no excuse for blaming the home care workers when things of the organisers' doing go wrong 
4. 
   
5. With tight budgets, the organisers are under stress within any policy of not allowing travel time  
6. 
   
7. However, if they can't fight the policy, they can at least administer it in a humane way
8. 
   
9. They should understand more about the home care workers being piggy in the middle
10. 
    
11. The home care workers are also between the devil and the deep black sea
12. 
    
13. The devil drives the home care workers to their wits' end
14. 
    
15. The home care workers are drowning while not giving away to the caree that there's trouble at mill
16. 
    
17. The devil doesn't throw them a lifebuoy while shouting "Don't talk to the carees.".
18. 
    
19. And the caree says "Enough's enough.".

5   What changes are in the offing?

It's quite simple

5.1

Already, carers are reporting that their carees no longer receive financial support for their care.  That means that organisers step up the pressure for carers not to talk to their clients.

5.2

The number of carers doesn't diminish.  Organisers step up the selection criteria.  Keeping quiet is top of the list.  Carers feel that they have even less influence on the way they are treated.  They leave.  Organisers shrug their shoulders and look for the list.

pagetop here

6  Herefordshire Council - the truth

6.1

I have been to four meetings which focused on HC care policy and presented a paper based on this page.    Ian Gardner, the organiser of the first meeting, was given a copy of the paper (based on this) at the beginning with the request it was dealt with at some stage during the meeting.  It wasn't.  That made me even more determined to obtain the widest attention to the problems which local councils do not deal with.  

6.2

Invitation from Sukhdev Dosanjh Assistant Director Commissioning Adults and Wellbeing - to attend an engagement workshop re: Promoting Independence on Thursday 4th February.  I will be there + paper.

6.3

If you plan to go, the walls will probably be plastered with small-group discussion post-its and/or flipchart paper with group comments.  When asked what will happen to these, no satisfactory answer has been given within the four meetings I have attended.  Some who attend believe the meetings to be part of a white-washing exercise.

6.4

The first meeting I attended was for unpaid carers.  The emphasis was on small group work.  When this was to be continued  I called for an end to the small group work so that we could discuss the wider issues.  Ian Garnder did all he could to avoid that until other voices said that I was right.

6.5

The remaining meetings comprised mainly organisations.  These meetings were more purposeful than the first.

more - Paper presented to Promoting Independence on 4th February 2016 here

Social Care Institute for Excellence, 206 Marylebone Road, London NW1 6AQ

T: 020 7535 0900 | F: 020 7535 0901 

pagetop here     for pasting           SCIE - Social Care Institute for Excellence    here

                                                       Carers and computer use here

                                                       Dementia Home page here

                                                       A paper distributed to Promoting Independence on 4th February 2016 is here.

                                                       Return to My care stories here

 pagetop here

A black picture often within the domain of dom-care staff on zero-hours contract, with disallowed travel time - here

Return to   My care stories here